Certification For Listing In The Connecticut Tobacco Directory {TPM-2}

Form TPM-2 -- CERTIFICATION FOR LISTING IN THE CONNECTICUT TOBACCO DIRECTORY AS OF JULY 1, 2025. This application will not be processed or considered complete until all the information and documents required, either by the application form, the instructions to the application form, or by the request of the Department of Revenue Services (DRS) or the Office of the Attorney General State of Connecticut (“Attorney General”), have been submitted. This form is used for certifying the listing of tobacco products in the Connecticut Tobacco Directory. It requires detailed information from both participating and nonparticipating manufacturers, including business details, manufacturing facilities, licenses, and compliance with regulations. It includes general business information, such as the manufacturer’s identity, facilities, and changes in manufacturers or brand families. The form requires identifying brand families, units sold, and product modifications, along with photos of packaging and labeling. Additional business information for nonparticipating manufacturers involves details about organizational documents, officers, directors, and affiliates, as well as sales and escrow deposits. The form covers marketing and distribution, including reclassified tobacco products, distributors, and compliance with reporting requirements. It also includes manufacturing and compliance information on importers, health warning rotation plans, ingredient reporting, and packaging compliance. The form requires disclosure of any enforcement actions, denials, or legal issues related to tobacco sales. For nonparticipating manufacturers, there is a section for imported cigarettes documentation, including importers, ingredient reporting, and trademark holder consent. The form concludes with an NPM applicant certification to confirm qualified escrow funds, valid agreements, and proper documentation for escrow deposits and withdrawals. www.FormsWorkflow.com